Provider Demographics
NPI:1083615033
Name:MAKIA, ASEK NELSON (MD)
Entity Type:Individual
Prefix:DR
First Name:ASEK
Middle Name:NELSON
Last Name:MAKIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 429
Mailing Address - Street 2:
Mailing Address - City:BURTONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20866-0429
Mailing Address - Country:US
Mailing Address - Phone:301-324-7338
Mailing Address - Fax:
Practice Address - Street 1:10274 LAKE ARBOR WAY STE 201
Practice Address - Street 2:
Practice Address - City:MITCHELLVILLE
Practice Address - State:MD
Practice Address - Zip Code:20721-3146
Practice Address - Country:US
Practice Address - Phone:301-324-7338
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD16084207KA0200X
MDD0032003208000000X, 207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC029477600Medicaid
MD377591700Medicaid
DC116697ZARLMedicare PIN
MD377591700Medicaid